Drug repurposing approach to fight COVID-19

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Drug repurposing approach to fight COVID‑19 Thakur Uttam Singh1 · Subhashree Parida1 · Madhu Cholenahalli Lingaraju1 · Manickam Kesavan1 · Dinesh Kumar1 · Raj Kumar Singh2 Received: 16 May 2020 / Revised: 20 August 2020 / Accepted: 24 August 2020 © Maj Institute of Pharmacology Polish Academy of Sciences 2020

Abstract Currently, there are no treatment options available for the deadly contagious disease, coronavirus disease 2019 (COVID19). Drug repurposing is a process of identifying new uses for approved or investigational drugs and it is considered as a very effective strategy for drug discovery as it involves less time and cost to find a therapeutic agent in comparison to the de novo drug discovery process. The present review will focus on the repurposing efficacy of the currently used drugs against COVID-19 and their mechanisms of action, pharmacokinetics, dosing, safety, and their future perspective. Relevant articles with experimental studies conducted in-silico, in-vitro, in-vivo, clinical trials in humans, case reports, and news archives were selected for the review. Number of drugs such as remdesivir, favipiravir, ribavirin, lopinavir, ritonavir, darunavir, arbidol, chloroquine, hydroxychloroquine, tocilizumab and interferons have shown inhibitory effects against the SARS-CoV2 invitro as well as in clinical conditions. These drugs either act through virus-related targets such as RNA genome, polypeptide packing and uptake pathways or target host-related pathways involving angiotensin-converting enzyme-2 (ACE2) receptors and inflammatory pathways. Using the basic knowledge of viral pathogenesis and pharmacodynamics of drugs as well as using computational tools, many drugs are currently in pipeline to be repurposed. In the current scenario, repositioning of the drugs could be considered the new avenue for the treatment of COVID-19. Keywords  Repurposing · SARS-CoV2 · COVID-19 · Coronavirus

Introduction Drug repurposing is the process to identify the new indications for existing drugs and considered as an efficient and economical approach [1]. It is also known as repositioning, re-profiling, re-tasking and rescue of drugs [2]. It has been considered that 75% of known drugs could be repositioned for various diseases [1]. Outbreaks of novel emerging infections such as coronavirus disease 2019 (COVID-19) have unique challenges in front of the health professionals to select appropriate therapeutics/pharmacological treatments in the clinical setup with very little time available

* Thakur Uttam Singh [email protected]; [email protected] 1



Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India



Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India

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for the new drug discovery [3]. Further, development of a vaccine for any disease including COVID-19 takes time and even if the process is put on accelerated mode it would take 18–20 months to